Treatments and drugs

A congenital heart defect may have no long-term effect on your child's health — in some instances, such defects can safely go untreated. Certain defects, such as small holes, may even correct themselves as your child ages.

Procedures using catheterization. Some children and adults now have their congenital heart defects repaired using catheterization techniques, which allow the repair to be done without surgically opening the chest and heart. In procedures that can be done using catheterization, the doctor inserts a thin tube (catheter) into a leg vein and guides it to the heart with the help of X-ray images.

Once the catheter is positioned at the site of the defect, tiny tools are threaded through the catheter to the heart to repair the defect. Catheter procedures can often be used to fix holes or areas of narrowing.

To correct a hole in the heart, such as an atrial septal defect, a catheter is threaded through a blood vessel to the hole. The catheter is equipped with an umbrella-like device that is opened and left in place. This plugs the hole, and over time, normal tissue grows over the device.

To repair areas of narrowing, such as pulmonary valve stenosis, a catheter is equipped with a small balloon that's inflated in the area that's narrowed. This creates a wider area for blood to flow through.

Open-heart surgery. In some cases, your child's doctor can't fix your child's heart defect using a catheter procedure. In these cases, your child may need surgery to repair the defect.

The type of surgery your child needs depends on the extent of the defect. For some congenital heart defects, such as holes in the heart, minimally invasive heart surgery may be an option. However, congenital heart defects are usually corrected using open-heart surgery.

Either type of surgery requires stopping the heart temporarily and using a heart-lung machine to circulate the blood throughout the body during surgery. The big difference between the two surgeries is that in a minimally invasive procedure, surgeons can operate through the ribs using only small holes. In open-heart surgery, the chest has to be opened.

These surgeries are major medical procedures and may require a significant recovery time for your child.

Heart transplant. If a serious heart defect can't be repaired, a heart transplant may be an option.

Medications. Some mild congenital heart defects, especially those found later in childhood or adulthood, can be treated with medications that help the heart work more efficiently. And, sometimes, congenital heart defects can't be operated on, or can't be completely repaired. In these cases, medication may be an option.

Drugs known as angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), beta blockers, and medications that cause fluid loss (diuretics) can help ease stress on the heart by lowering blood pressure, heart rate and the amount of fluid in the chest. Certain medications can also be prescribed to help irregular heartbeats (arrhythmias).

Sometimes, a combination of treatments is necessary. In addition, some catheter or surgical procedures have to be done in steps, over a period of years. Others may need to be repeated as a child grows.

Long-term treatment

Some children with congenital heart defects require multiple procedures and surgeries throughout life. Although the outcomes for children with heart defects have improved dramatically, most people, except those with very simple defects, will require ongoing care, even after corrective surgery.

Lifelong monitoring and treatment. Even if your child has surgery to treat a heart defect, your child's condition will need to be monitored for the rest of his or her life.

Initially, this is done by a pediatric cardiologist, and then an adult cardiologist. A congenital heart defect can affect your child's adult life, as it can contribute to other health problems.

As your child ages, it's important to remind him or her of the heart condition that was corrected and the need for ongoing care. Encourage your child to keep his or her doctor informed about the heart defect and the procedures performed to treat the problem.

Exercise restrictions. Parents of children with congenital heart defects may worry about the risks of rough play and activity even after treatment. Although some children may need to limit the amount or type of exercise, many can participate in normal or near-normal activity.

Your child's doctor can tell you which activities are safe for your child. If some activities do pose distinct dangers, encourage your child to participate in other activities instead of focusing on what he or she can't do. Although every child is different, most children with congenital heart defects grow up to lead healthy, productive lives.

Infection prevention. Depending on the type of congenital heart defect your child had, and the surgery used to correct it, your child may need to take extra steps to prevent infection.

Sometimes, a congenital heart defect can increase the risk of infections — either in the lining of the heart or heart valves (infective endocarditis). Because of this risk, your child may need to take antibiotics to prevent infection before additional surgeries or dental procedures.

Children who are most likely to have a higher risk of infection include those whose defect was repaired with a prosthetic material or device, such as an artificial heart valve. Children who've had surgery to place a prosthetic device in the previous six months also face a higher risk of infection. Ask your child's cardiologist if preventive antibiotics are necessary for your child.

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